Search Results (84)

Background/Objectives: Rabies remains a lethal vaccine-preventable disease in India, and physicians managing animal-bite cases are central to effective post-exposure prophylaxis (PEP). With the increasing use of rabies monoclonal antibodies (RmAbs) as alternatives to conventional rabies immunoglobulins, this study assessed physicians’ knowledge, attitude, and practice (KAP) regarding rabies PEP, including RmAb awareness and acceptance. Methods: This multi-state, cross-sectional retrospective KAP survey was conducted among 208 physicians across ten Indian states using a structured, self-administered Google Form. The 33-item questionnaire assessed Knowledge, Attitude, and Practice domains, with 11 items each, scored binarily according to NCDC guidelines. Descriptive statistics, Shapiro–Wilk normality testing, Kruskal–Wallis tests with post hoc corrections, and Spearman rank-order correlations were performed. Results: Mean domain scores were 8.00/11 for Knowledge (72.7%), 7.22/11 for Attitude (65.6%), and 8.64/11 for Practice (78.5%). Key gaps were identified in the intramuscular pre-exposure prophylaxis schedule, management of excess RIG/RmAb after wound infiltration, exposure categorization of animal contact, and vaccine administration site in young children. The Knowledge–Practice correlation was moderately strong and statistically significant (r = 0.520, p < 0.001). Acceptance of RmAbs was high, with 88.5% recognizing them as effective replacements for RIGs and 84.6% considering them safer than RIGs. Practice scores showed the most consistent improvement, Knowledge scores improved on most items but declined sharply for the pre-exposure prophylaxis schedule, and Attitude scores showed a mixed pattern of gains and losses compared with the 2013 benchmark survey. Conclusions: Overall KAP scores were adequate, with Practice scoring highest. Targeted continuing medical education focused on NCDC guidelines and practical PEP scenarios is needed among physicians managing rabies exposures. Full article

Environmental education is crucial for promoting sustainable behavior, yet maintaining engagement across educational transitions remains challenging. Drawing on the Theory of Planned Behavior (TPB), this study examined how high school experiences influence pro-environmental behavior (PEB) during the transition to university. We integrated sense of school belonging (SB) and pro-environmental innovative behavior (IB) as school-based antecedents to the TPB framework. A retrospective survey was conducted with 1879 first-year university students, and structural equation modeling (SEM) was used to test the hypothesized relationships. Results provided robust support for the integrated model. Consistent with TPB, attitudes, subjective norms, and perceived behavioral control significantly predicted pro-environmental intention, which subsequently predicted actual PEB. Both IB and SB emerged as significant predictors of these cognitive factors, with SB also promoting engagement in innovative activities. The model explained 72.4% of the variance in intention and 37.5% in actual behavior. Multigroup analysis revealed that while the structural model was stable across gender, certain pathway strengths varied. These findings offer empirical evidence for the retrospective associations of pro-environmental behavior, demonstrating that the recalled social–emotional and experiential contexts of high school are consistently related to university students’ current environmental actions. This study extends the TPB by highlighting the developmental role of school environments in fostering long-term environmental responsibility. Full article

The rapid integration of artificial intelligence (AI) accelerates the need for continuous skill acquisition. Consequently, this increases the importance of lifelong learning while raising fundamental questions about pedagogical interaction and human social values. To remain competitive, individuals must constantly acquire new skills and enhance existing ones. The aim of the article is to evaluate the stability of individual social value systems and the role of pedagogical interaction in lifelong learning during AI integration. The study uses a quantitative survey (N = 160) with a retrospective self-assessment model based on Schwartz’s Theory of Basic Human Values. The study processed data in IBM SPSS using non-parametric tests (Wilcoxon signed-rank, Kruskal–Wallis, Kendall’s rank correlation) to analyze how digital skills and sociodemographics influence technology perception. Findings reveal core value systems remain statistically stable; AI integration causes no internal value conflict. Digital skill level, rather than age, is the most significant factor in AI perception. While participants highly rate AI’s potential to customize learning, they express concerns regarding technological dependence. In the lifelong learning ecosystem, AI is viewed as a didactic tool rather than an educator replacement, as technology cannot provide essential social interaction and emotional support. Finally, higher education fosters a critical attitude toward AI’s ethical risks. Full article

The global expansion of the gaming industry has intensified scholarly interest in the cultural and psychological implications of digital gameplay. This study examines how gameplay experiences are associated with adolescents’ and young adults’ attitudes toward traditional culture and national pride, focusing on how myth-based digital games can function as interactive vehicles for cultural heritage engagement. Using Black Myth: Wukong, a contemporary action role-playing game inspired by the Chinese literary classic Journey to the West, the study investigates the psychological mechanisms through which gameplay extends into longer-term cultural evaluation. Drawing on Self-Determination Theory, gameplay experience was conceptualized in terms of autonomy, competence, and relatedness, while Retrospective Imaginative Involvement (RII) was introduced to capture post-play imaginative recall and narrative elaboration. Survey data were collected from 312 Chinese adolescents and young adults who had played Black Myth: Wukong, and structural equation modeling was employed to test the relationships among gameplay experience, RII, traditional cultural attitudes, and national pride. The findings indicate that need-satisfying gameplay is positively associated with retrospective imaginative involvement, which in turn is linked to more favorable attitudes toward traditional culture and stronger national pride. The study suggests that the cultural influence of digital games extends beyond the moment of play and continues through reflective post-play processing. Theoretically, it contributes to research on media effects, narrative engagement, and digital heritage by identifying RII as a key post-play mechanism. Practically, it highlights the potential of culturally grounded games to support heritage communication and youth-oriented cultural engagement. Full article

Objective: Influenza and pertussis vaccines are recommended during pregnancy; however, uptake remains insufficient in many European countries, increasing the risk of preventable infections. Recent recommendations for maternal respiratory syncytial virus vaccination have been endorsed by scientific societies. This study evaluated maternal vaccination coverage, knowledge, attitudes, and factors influencing vaccine uptake among Lithuanian women. Methods: A retrospective cross-sectional online survey was conducted between 4 and 14 November 2025 in Lithuania among women aged 18–55 years with at least one previous pregnancy. The questionnaire contained 29 questions on sociodemographic characteristics, obstetric history, vaccination history, attitudes, and informational sources influencing decisions. Internal reliability was confirmed (Cronbach’s α = 0.83). Descriptive statistics were used to summarize the data. Associations between categorical variables were assessed using the Chi-square test or exact tests (Fisher’s exact or Fisher–Freeman–Halton). Binary and multivariable logistic regression analyses were performed to evaluate factors associated with self-reported vaccination uptake and the relationship between influenza and pertussis vaccination. Odds ratios with 95% confidence intervals were calculated. Statistical significance was set at p < 0.05. Results: A total of 241 women participated. Self-reported vaccination coverage during pregnancy was 28.7% for influenza, 43.8% for tetanus–diphtheria–pertussis, and 4.2% for respiratory syncytial virus. Physician’s recommendation was the strongest predictor: women advised to vaccinate were 17.0 times more likely to receive influenza, 16.5 times more likely to receive pertussis, while RSV vaccination occurred almost exclusively among women who reported receiving a physician’s recommendation. Higher uptake was associated with younger maternal age and university education. Reasons for declining vaccination were avoidance of medical interventions and concerns about safety or side effects. Conclusions: Maternal vaccination coverage in Lithuania remains low despite public funding and national recommendations. Strengthening provider communication, improving information strategies, and integrating vaccination counseling into routine antenatal care may increase uptake and enhance maternal and neonatal protection. Full article

Farm-to-school initiatives, including school gardens, are an increasingly popular strategy to increase student access to healthy produce and nutrition education opportunities. While studies show school garden programs and garden-enhanced nutrition education can positively impact student consumption of fruits and vegetables, there is a gap in evaluation tools that can be used by practitioners across varied school sites, grades, and communities, to assess outcomes of their garden programs. This effort piloted the Student Garden Retrospective Survey (SGR) for grades 4+ in four classrooms in two counties in California. The instrument included items to measure program exposure, garden skill experiences, changes in students’ behaviors, preferences, and attitudes, as well as their perceptions of the program. Student and teacher feedback on the evaluation tool was gathered to determine if students understood the questions being asked, were able to complete the survey, and whether the evaluation questions were pertinent to their school gardening experiences. The results demonstrate that the SGR is suitable for evaluating school garden and garden-enhanced nutrition education programming. In the future, the evaluation tool can be used by practitioners to iteratively improve garden-based education to enhance students’ nutrition and health outcomes. Full article

Past research has consistently demonstrated the negative effects of interpersonal mistreatment on student experiences by employing retrospective studies; however, little is known about the daily effects that could lead to career derailment. The present study advances evidence of the consequences of experiencing multiple forms of interpersonal mistreatment, including sexual harassment, racial harassment and microaggressions, and incivility (collectively labeled HARM) by employing an experience sampling methodology (ESM) to estimate the immediate impact of HARM on career-relevant attitudes among a sample of 202 biomedical health trainees (mentees) funded by a National Institutes of Health fellowship. Grounded in Affective Events Theory, we found that mentees’ daily experiences of HARM were associated with an immediate degradation of their attitudes toward their training program mediated by negative affect. Being racially isolated in a lab or having a racially different mentor increased the prevalence of HARM; moreover, accounting for negative affect, experiences of HARM were positively associated with program attitudes for mentees who were racially well-represented, suggesting that majority status may buffer the negative impact of HARM on attitudes. Understanding these dynamics provides insight into the importance of assessing and addressing daily experiences of mistreatment among graduate and postdoctoral trainees. Full article

This exploratory mixed-methods study examined whether a narrative-driven digital gamification platform, FantasyClass, grounded in the MDA (Mechanics–Dynamics–Aesthetics) framework and Bartle’s player typology (used as a cohort-level design input), was associated with science attitudinal change in preservice primary teachers. The quantitative component employed a one-group pretest–posttest (pre-experimental) within-participant design using a validated 22-item attitudes questionnaire (N = 23), structured across three temporal dimensions: past (retrospective experiences), present (current perceptions), and future (teaching expectations). Significant improvements were observed across all attitudinal dimensions with large effect sizes, most notably in students’ future expectations and confidence to teach science. Exploratory correlation analyses indicated that participants’ perceived motivational value of narrative and immersion elements was moderately associated with Future-dimension attitudinal gains. Qualitative thematic analysis of open-ended responses (n = 15) revealed enhanced motivation, reduced science anxiety, more positive perceptions of physics and chemistry, and strong intentions to adopt game-based and gamified strategies in future teaching practice. Convergence across quantitative and qualitative strands suggests that structurally coherent, player-type-informed narrative gamification may be associated with attitudinal transformation and early professional identity development in STEM teacher education, while recognizing that the design does not permit causal attribution. Full article

Background/Objectives: People suffering from mental illnesses are more likely to experience adverse social and health outcomes. Various interventions have been shown to help people with mental illness achieve better results in terms of symptom reduction, functional status, and quality of life. Psychiatric rehabilitation interventions integrate evidence-based practices, promising approaches, and emerging methods that can be effectively implemented to enhance health outcomes in this population. This study aims to examine whether the rehabilitative treatment provided to a group of patients with mental illness leads to improvements in health outcomes and psychiatric symptomatology. Methods: This study employed a retrospective quasi-experimental design. Data were collected between 2023 and 2025 within the Partial Hospitalization Program of the Psychiatry and Mental Health Service of Soria (Spain). The sample consisted of 58 participants who received rehabilitative treatment in this setting. Data were collected at the time of patients’ admission and at discharge. Gender, age, psychiatric diagnosis according to ICD-10, and the average length of stay in the rehabilitation program were assessed. The questionnaires administered were psychometrically validated scales related to heteroaggressiveness, perceived quality of life, global functioning, attitudes toward medication, and the risk of suicide. Results: A significant improvement was observed in the Global Assessment of Functioning (GAF) Scale (t = −7.1, p < 0.001), with mean scores increasing from 42.17 at admission to 69.13 at discharge. Additionally, reductions in suicidal risk and hetero-aggressive behavior were noted, alongside improvements in quality of life and treatment adherence. Conclusions: The findings highlight the effectiveness of implementing activities and programs focused on psychiatric rehabilitation processes to promote positive health outcomes. Future research directions and practical implications are discussed to support the continued development and optimization of psychiatric rehabilitation programs. Full article

Background/Objectives: Vaccination programs are highly effective public health interventions, yet parental hesitancy toward combination vaccines has led to growing demand for alternative vaccination schedules, defined in this study as parental requests to split or replace recommended combination vaccines with single-antigen vaccines for non-clinical reasons. While parental attitudes have been widely studied, little empirical evidence exists on the real-world use of single-antigen vaccines and their public health implications in countries with otherwise high coverage. This study examined the prevalence patterns and parental motivations for requesting such alternative vaccination schedules in Israel, where national guidelines recommend specific combination vaccines, including measles-mumps-rubella-varicella (MMRV) and the pentavalent diphtheria-tetanus-pertussis–inactivated polio–Haemophilus influenzae type b (DTaP+IPV+Hib) vaccines, but informal accommodations exist. Methods: A mixed-methods design was employed: a retrospective cohort analysis of vaccination data from 2018 to 2021 (before and during the COVID-19 pandemic) focused on measles (first dose at 12 months) and pertussis (four-dose primary series), followed by semi-structured interviews with Maternal and Child Health clinic providers, policymakers, and parents. Results: Alternative vaccination schedules involving single-antigen measles or pertussis vaccines are occasionally used despite official policy, accounting for less than 1% of vaccinations overall. Outcomes include delayed administration, lower uptake of combination vaccines, and incomplete protection in certain groups. Parents cited safety concerns, fear of immune overload, and mistrust of authorities. These concerns were often amplified by misinformation, while providers described balancing parental preferences with the need for adequate coverage. Conclusions: This study provides new evidence on how vaccine hesitancy translates into service utilization, highlights the tension between individualized parental decision-making and contribution to collective health, and underscores the need for communication, policy strategies and service designs that sustain high coverage while addressing community-specific concerns. Full article

Background: Prostate cancer is a major public health concern in Ghana, where most cases present late and mortality remains high. Community education is essential for improving awareness and early detection. Traditional health talks are widely used, but interactive approaches such as board games have received little evaluation. Aim: To compare the effectiveness of a Social Cognitive Theory–Socioecological Model-based literacy board game (S-S-LIBOG) with a traditional health talk in improving prostate cancer knowledge, attitudes, and perceptions. Methods: A quasi-experimental, two-arm interventional study was conducted in a semi-urban Ghanaian cohort. Participants (n = 197) were allocated to either the board game arm (n = 80) or the health talk arm (n = 61) after accounting for attrition. A structured questionnaire measured knowledge, attitudes, and perceptions (KAP) before and after intervention. Statistical analyses at 5% alpha level included chi-square tests, two-proportion Z-tests, Wilcoxon signed-rank tests, and multivariate logistic regression. Results: Among participants, 29.4% were female, 64.5% male, and 6.1% other genders. Tertiary education was reported by 81.7%, secondary 9.6%, postgraduate 5.6%, and primary 3.0%. Ethnicities: Ewe 41.6%, Akan 26.9%, Northern 13.7%, Ga 6.6%, Guan 1.5%, others 9.6%. Rural dwellers: 29.9%. LIBOG improved ‘good knowledge level’ from 35.0% at baseline to 60.0% post-intervention, compared to 35.0% to 62.3% by the Health Talk (HT). S-S-LIBOG also narrowed gender, education, and lifestyle disparities in KAP, with males showing higher odds of positive attitude (OR = 4.16, p = 0.004) and perception (OR = 2.79, p = 0.047), and rural residents having increased odds of good knowledge (OR = 4.39, p = 0.041) post—its intervention. HT similarly equalized disparities, except for perception, which remained linked to education. The significant improvements in knowledge were (LIBOG: z = 2.85, p = 0.004; HT: z = 3.10, p = 0.002). Even though health talks achieved higher overall knowledge gains, no statistically significant difference in overall effectiveness was observed between the two methods (Wilcoxon W = 102.0, p = 0.107). Acceptability of the board game was high, with over 80% of participants reporting satisfaction. Conclusions: The S-S-LIBOG board game was not inferior to the traditional health talk, showing particular strengths in enhancing attitudes and perceptions. Its interactive and culturally adapted design makes it a feasible adjunct to conventional health education methods. Future studies should examine long-term impacts and application in more diverse populations. This study was retrospectively registered by the Pan African Clinical Trial Registry on 10 October 2025; with the Trial Registration number PACTR202510512711680. Full article

Background: Human papillomavirus (HPV) vaccination remains a critical preventive strategy against HPV-related cancers, yet uptake among young adults in Poland remains suboptimal. Objectives: This study aimed to assess HPV vaccination status, determinants, and perceived barriers to vaccination among healthcare students. Methods: This retrospective survey was conducted among 1062 students of the Medical University of Lodz, including those studying Medicine, Nursing, Midwifery, and Public Health. Results: Overall, 20% of respondents reported HPV vaccination, with the highest coverage among midwifery students (26.8%) and the lowest among medical students (16.8%). The major barriers to vaccination were found to be cost and misconceptions regarding vaccination age limits. As most respondents were above 14 years old when receiving the first dose, they were not eligible for the national free vaccination program. The significant motivators were parental influence and guidance from the medical university; however, recommendations for vaccination were infrequent. Multivariable logistic regression analysis found marital status (p = 0.029), paternal medical education (p = 0.003), and prior sexual experience (p = 0.037) to be significantly associated with vaccination status. Adverse events were reported by 45% of vaccinated respondents, most commonly reactions at the injection site. Nursing and midwifery students more often perceived adverse events as moderate or severe, but none discontinued vaccination. Conclusions: These findings underscore the need for financial support mechanisms and targeted educational interventions to enhance HPV vaccine uptake among future healthcare professionals in Poland. Full article

Aim: To assess the impact of the environment on the attitude and mood of pediatric patients undergoing computed tomography (CT) scans at our pediatric clinic within the colorful setting of a dedicated CT scan room. Background: In pediatric healthcare, interventions must address the specific needs of both children and their parents. While medical imaging is essential for diagnosis and management, it can cause stress and anxiety in children, potentially affecting cooperation and diagnostic quality. Creating a supportive, child-friendly environment can alleviate these challenges and improve the likelihood of successful imaging outcomes. Method: This retrospective quantitative study investigated the phenomenological experience of pediatric patients (aged 0–18) who underwent CT imaging at the “De Marchi” pediatric clinic between November 2021 and June 2024. Patients were manually selected from the clinic’s CT database. A standardized telephone survey assessed perceived environmental impact before, during, and after the procedure. Data were anonymized and recorded in Excel (Microsoft, Redmond, WA, USA). Crosstab analyses and Pearson’s chi-square tests were performed using SPSS version 25.0 (IBM, Armonk, NY, USA). Results: Between November 2021 and June 2024, 838 pediatric patients underwent 1144 CT scans at the “De Marchi” clinic. Patients were grouped as previous-CT elsewhere (12.3%), first-time CT (68.9%), and returning patients (18.8%). Most reported positive experiences: 63.3% of the first group rated the experience better than prior exams, 73.9% of first-time patients found the environment comfortable, and 85.6% of returning patients felt at ease. Overall, 94.2% would recommend the clinic for pediatric CT scans. Conclusions: Our research demonstrates that a child-friendly environment is not just a concept, but a tangible solution that effectively alleviates the stress experienced by young patients and their families during diagnostic exams. This finding should inspire optimism about the potential for creating more reassuring and comfortable hospital settings in pediatric healthcare. Full article

Background: Hansen’s disease or leprosy is one of the 21 neglected tropical diseases (NTDs). In Ecuador, leprosy is considered eliminated as a public health problem; however, new cases are reported annually. Additionally, Mycobacterium leprae infection was detected in nine-banded armadillos across the country, suggesting a potential zoonotic reservoir. This literature review aims to provide an updated overview of the epidemiological situation of leprosy in Ecuador, identify knowledge gaps, and outline research priorities to support the development of a comprehensive national strategy for achieving zero autochthonous cases. Methods: This article analyses the current situation of leprosy in Ecuador based on international and national publications. A retrospective literature search using five international, regional, and national publications on leprosy published between 1954 and 2024 (70 years) with no restriction on language or publication date, was performed. Findings: Our review identified 28 publications with the earliest article dating back to 1954. Of these, 14 were published in international journals, 15 (53.6%) were in Spanish. Four nationwide studies documented leprosy cases across Ecuador’s three continental regions (Coast, Andes, and Amazon) with a predominance in the tropical coast. No cases have been reported from the Galápagos Islands. From 1983, Ecuador started multi-drug therapy. Data from the Ministry of Public Health (MoH) system identified 1539 incident cases, showing a significant decline in new cases from 2000 to 2024, with no cases in children. New cases detection rate by 100,000 inhabitants was 0.51 in 2019 according to the World Health Organization (WHO). No study has genotyped the Mycobacterium spp. in human cases, other animal species, or environment. According to the MoH, multibacillary leprosy accounts for 78.95% of diagnosed cases, with confirmation based on Ziehl–Neelsen staining and histopathology. No survey has assessed disabilities, knowledge, attitudes, and practices (KAP) or stigma related to leprosy. Research is needed on transmission routes, Mycobacterium genotyping, genetic susceptibility, and antibiotic resistance. BCG vaccination coverage fell to 75.3% in 2021. Cases are currently diagnosed and treated on an outpatient basis in large hospitals. Conclusions: This comprehensive review highlights persistent gaps in leprosy research and critical information, despite seven decades of documented cases in Ecuador. The disease is still endemic across the country, particularly at subnational level in the subtropics and tropics of the Pacific coast and the Amazon. There is a need for nationwide epidemiological research on reservoirs and the environment applying the One Health concept. Increased laboratory facilities and readily available official data are required to improve our understanding of leprosy in Ecuador. Strengthening community-level efforts is essential for Ecuador to meet the targets of the “WHO’s Towards Zero Leprosy: Strategy 2021–2030.” Full article

Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition with a complex and multifactorial etiology, diagnosed on the basis of clinical criteria. Medical comorbidities are common and often lead to instrumental examinations; however, the clinical utility of routinely performing such tests remains uncertain. This study aimed to assess the practical value of instrumental assessments in ASD by examining both prescribing behaviors and the prevalence of abnormal findings in a sample of autistic children. Methods: A combined-method approach was adopted: (1) an online survey of child neuropsychiatrists across the Piedmont region (Italy) explored current attitudes and practices regarding instrumental testing in children with ASD; (2) a retrospective cross-sectional analysis examined the frequency and clinical relevance of abnormal findings in ASD patients who underwent comprehensive testing at a tertiary hospital in Turin. Results: The survey showed that 85.7% of centers follow specific protocols for instrumental examinations, though practices vary considerably. Genetic testing and blood analyses are routinely performed, while EEG, MRI, audiometry, and metabolic screenings are generally based on clinical indication. In the retrospective study, instrumental tests revealed a low rate of clinically significant findings. Clinically relevant genetic abnormalities were detected in 7.9% of CGH-array tests. EEG abnormalities were seen in 9% of cases, though 57% had nonspecific or unclear results. Among biochemical parameters, notable findings included altered lipid profiles (45%), ferritin deficiency (24%), and anemia (12.5%) and no metabolic disorders were identified. Discussion: These findings highlight substantial variability in clinical practice and suggest that while some instrumental tests may provide valuable insights, routine screening is often of limited benefit. The high prevalence of nonspecific findings reinforces the need for careful clinical correlation, emphasizing the importance of balancing comprehensive assessment against the risks of over-testing and challenges in interpreting results. Future research should focus on developing evidence-based guidelines for instrumental assessments in this population. Full article